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DM Neuro 1 > Aphasia > Flashcards

Aphasia Flashcards

1
Q

Define communication

A
  • active process of exchanging information and ideas
  • includes: gestures, vocalizations, verbalizing, signs, pictures, symbols, printed word, and output from augmentative and alternative (AAC) devices
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2
Q

what is the difference between receptive and expressive language?

A
  1. Expressive → ability to communicate one’s thoughts, ideas and feelins
  2. Receptive → ability to understand what another person is communicating
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3
Q

Which cranial nerves are involved with speech?

A

CN V, VII, IX, X and XII

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4
Q

what is the general function of CN IX?

A
  1. Taste
  2. Swallowing
  3. Elevation of pharynx and larynx
  4. Parotid salivary gland
  5. Sensation to posterior tongue and upper pharynx
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5
Q

What is the general function of CN X?

A
  1. Taste
  2. Swallowing
  3. Elevation of palate
  4. Phonation
  5. PNS outflow to visceral organs
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6
Q

What is the Central Language Mechanism?

A

essentially how the brain functions when we’re talking and comprehending speech

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7
Q

What are the brain regions and major components of the Central Language Mechanism?

A
  1. Broca’s Area
  2. Primary motor cortex
  3. Arcuate fasciculus
  4. Angular gyrus
  5. Wernicke’s area
  6. Supramarginal gyrus
  7. Corpus callosm
  8. Subcortical regions:
    • Thalamus
    • Internal capsule
    • Striatum
    • Globus pallidus
    • White matter tracts
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8
Q

what is Broca’s area responsible for?

A

Motor programming for articulation

(expression of language)

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9
Q

what is the role of the primary motor cortex regarding speech?

A

activation of muscles for articulation

(dorsal frontal lobe)

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10
Q

what is the role of the Arcuate fasciculus?

A

transmission of linguistic info to anterior areas from posterior areas

(bundle of axons that generally connects the Broca’s area to Wernicke’s)

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11
Q

What is the role of the Angular gyrus?

A

integrates visual, auditory, and tactile info and carries out symbolic integration for reading

(parietal lobe)

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12
Q

what is the role of Wernicke’s area?

A

comprehension of oral language

(temporal lobe)

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13
Q

what is the role of the supramarginal gyrus?

A

symbolic integration for writing

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14
Q

what is the role of the corpus callosum regarding speech?

A

transmission of info between hemispheres

  • C-shaped nerve fiber bundle found above the thalamus, under the cortex
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15
Q

what is the role of the thalamus regarding speech?

A

naming and memory mechanisms

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16
Q

What is the role of internal capsule, striatum, and globus pallidus regarding speech?

A

play a general role in speech and language

part of the basal ganglia

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17
Q

What is aphasia?

A

Neurogenic language disorder resulting from an injury to the brain

(typically the L hemisphere)

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18
Q

Aphasia can happen in all 4 language modalities: ___________________

A
  1. expressive language
  2. receptive language
  3. reading
  4. writing
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19
Q

List the 8 dimensions of Aphasia

A
  1. Fluent versus nonfluent
  2. Grammatical integrity
  3. Volitional reception
  4. Auditory comprehension
  5. Writing disorder
  6. Reading disorder
  7. Expression of names
  8. Response dynamism
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20
Q

what is generally included in testing for aphasia?

A
  1. Naming task → visual confrontation
  2. Speech sample → spontaneous conversation
  3. Repetition
  4. Comprehension of spoken language
  5. Reading
  6. Writing
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21
Q

Fluent speech aphasia goes with ______

A

Wernicke’s aphasia

22
Q

Nonfluent speech aphasia goes with _______

A

Broca’s Aphasia

23
Q

how is fluent speech defined?

A

rate of speech, length of utterance, ease of production, prosody

24
Q

Describe a fluent speech pattern

A
  1. Long utterance → 9 or more word per utterance
  2. Utterances are easily produced
  3. Prosody is normal
  4. Logorrhea → produces lots and lots of speech
  5. Pressed for speech → the person seems compelled to keep going, getting out lots of ideas through fast and continuing ideas
25
Q

Describe a nonfluent speech pattern

A
  1. rate is slow (10-50 wpm) with lots of pauses
  2. utterances are short 1-3 words
  3. speaking seems effortful
  4. Prosody is often lost
26
Q

What is pure word deafness?

A

auditory verbal agnosia

person hears the word but cannot tell you the meaning of the word; inability to comprehend speech

27
Q

What is agraphia?

A

loss the ability to write

  1. Pure agraphia → agraphia is the only communication deficit resulting from focal lesion (very rare)
  2. Paragraphias → incorrect spelling errors caused by brain damage
28
Q

What is response dynamism? list the various types

A

utternaces that are uncontrolled; spontaneous conversation

  1. Stereotypy
  2. Verbal perseveration
  3. Pallilalia
  4. Echolalia
29
Q

define stereotypy

A

a short utterance used exclusively in all speaking attempts it can be a word of a phrase

monophasia → when a pt only has one word available (usually a swear word)

30
Q

what is verbal perseveration?

A

a word or phrase temporarily becomes the response to all stimuli

at the outset of this period, the response was appropriate to a particular stimulus

31
Q

what is pallilalia?

A

uninhibited repetition of one’s own utterances

“John Smith, John Smith”

32
Q

What is echolalia?

A

uninhibited repetition of another’s utterances

“where do you live? Where do you live?”

33
Q

List the various distinct aphasia syndromes

A
  1. Broca’s aphasia
  2. Transcortical Motor aphasia
  3. Global aphasia
  4. Anomic aphasia
  5. Conduction aphasia
  6. Wernicke’s aphasia
  7. Jargon aphasia
  8. Thalamic aphasia
  9. Subcortical aphasia
34
Q

Describe Broca’s Aphasia

A
  1. Nonfluent aphasia
  2. usually an occlusion of L MCA (superior division)
  3. characterized with:
    • awkward articulation
    • restricted vocab
    • restriction to simple grammatical forms in the presence of a relative preservation of auditory comprehension
  4. Writing typically mirrors speech
  5. reading may be less impaired
35
Q

Describe Wernicke’s Aphasia

A
  1. Fluent Aphasia
  2. usually an occlusion to L MCA (inferior division)
    • lesion to posterior superior temporal gyrus
  3. Impaired auditory comprehesion and fluently articulated speech marked by word susbstitution
  4. Reading and writing usually severely impaired
  5. Speech often produced at greater rate than normal
  6. Production of speech is often precise - but pts my reverse phonemes and or syllables
36
Q

Describe Jargon Aphasia

A
  1. Fluent aphasia in which speech is incomprehensible but makes sense to the pt
  2. they either replace the word with a similar sounding one or its random
  3. associated w/Wernicke’s aphasia
37
Q

Describe Anomic Aphasia

A
  1. Word finding difficulty within fluent, grammatically well-formed speech
  2. lesion is variable but commonly in left angular gyrus
  3. Speech output is vague, pt may use circumlocution as a comp strategy
    • using wordy and indirect language to express ideas when unable to retrieve the desired word(s)
  4. these disturbances predominate aphasia secondary to TBI
  5. Anomia is the most prominent symptom w/only limited receptive/expressive deficits
  6. may appear as the isolated syndrome or be the final stage of recovery from others
38
Q

Describe Conduction Aphasia

A
  1. main impairment is inability to repeat words/phrases
  2. AKA associative aphasia
  3. mild form of aphasia and relatively rare
  4. Caused by lesion in arcuate fasciculus
39
Q

Describe Global Aphasia

A
  1. Severe aphasia w/complete dysfunction across ALL language modalities
  2. extensive damage, anywhere left hemisphere and sometimes bilateral
40
Q

Describe Transcortical Aphasia

A
  1. Wernicke’s term for any aphasic syndrome whose lesion falls outside of the Perisylvian area
  2. Ability to repeat w/good accuracy is retained
  3. 3 general types recognized
    • transcortical motor aphasia
    • transcortical sensory aphasia
    • mixed transcortical aphasia
41
Q

what is transcortical motor aphasia?

A
  • nonfluent speech w/greater effort required than Broca’s
  • repetition and comprehension intact
42
Q

what is transcortical sensory aphasia?

A

fluent speech marked with paraphasias w/semantic and neologistic substitutions, poor comprehension, good repetition

43
Q

What is mixed transcortical aphasia?

A

severely disordered language except in repetition.

Echolilias is common

44
Q

Describe subcortical aphasia

A
  1. generally characterized w/preserved repetition
  2. broken down into:
    • striato-capsular and white matter → lack of speech fluency, occurence of literary paraphasias, mainly preserved comprehension and naming
    • thalamic aphasia → relatively consistent fluent expressive speech and impaired comprehension marked by verbal paraphasia and neologisms. Auditory and reading comprehension usually remain intact
45
Q

Describe Progressive Aphasia

A
  1. this is a type of dementia
  2. characterized by:
    • gradual loss of language function in the context of relatively well-preserved memory, visual processing, personality until the advanced stages
  3. Anomia is often an early sign
  4. not due to stroke, trauma, tumor, or infection
  5. spontaneous recovery does not occur
46
Q

What is dysarthria?

A

impairment of speech production resulting from damage to the central or peripheral nervous system, causing weakness, paralysis or incoordination of motor speech

47
Q

list treatment options for dysarthria in acute care

A
  1. slow rate of speech
  2. over-articulate
  3. speak louder
48
Q

What is apraxia of speech?

A

reflects an impaired capacity to plan or program sensiromotor commands necessary for directing movements that result in normal speech

49
Q

T/F: apraxia of speech involves muscle weakness

A

FALSE

also doesn’t involve: paralysis, spasticity, or involuntary movements typically associated w/dysarthria

or language comprehension/production deficits common with aphasia

50
Q

how would you describe apraxic speech?

A

labored speech

difficult to initiate speech

periods of error free speech followed by errors as speech progresses

51
Q

T/F: individuals with aphasia sound normal when singing

A

FALSE

normal sounding w/singing = apraxia

52
Q

What is dysphagia?

A

swallowing disorder

common in stroke, brain injury, spinal cord injury, PD, MS and many other neurologic disorders

DM Neuro 1 (16 decks)

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